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11-AUGUST-2010  SUHAYR UMAR AL-HASAN  HUGE EXTRUDED DISC C6-7 CENTRAL MORE TO THE RIGHT AND LESSER EXTRUSION OF C5-6.

Please! wait for 3-5 min till the video start to load. It depends upon the internet connection.

Anamnesis

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The patient came to the clinic 01-August-2010 complaining of neck pain for 6 years with both shoulders pain more the right. The condition deteriorated the last month.

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MRI done 2004 showed extruded disc C5-6 with right foraminal occlusion.

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On examination: the patient has neck pain when looking down and to the right and agonizing pain with limitation of movement when looking up. There is hypalgesia of the right C5-6-7 roots territories and below the right knee. There is weak grip both hands more the right and extensors of the right hand and pronounced weakness of the right triceps muscle.

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The patient was sent for investigations and MRI of the lumbar spine was uneventful, but there is huge central extruded disc C6-7 more to the right compressing the spinal cord with old extruded disc C5-6.

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Discectomy of C6-7 was performed and removal of the all the extruded fragments compressing the spinal cord was achieved. Intradiscal cleaning of C5-6 was performed. Adequate Fidji cages were inserted to both levels with Novabone. Using Trinica Zimmer cervical plate 36 mm length 2 levels, fusion of C5-6-7 was done with screws 14 mm length. The construct was applied after removal of all the projecting anteriorly osteophytes. The gaps between the cages and anterior edges of the bones was filled by his own bone harvested from the ossified annulus fibrosis.

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Routine closure of the wound and smooth postoperative recovery.

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The power of the three limbs improved.


Comments

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So as to avoid future escalation of the PCD C5-6, it was included in the fusion plan.

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One level Prestige-LP was not a good idea because the bone was full of osteophytes and there was alertness about the slippage of the device in case of inserting it. For that reason the applied technique was estimated the best option for her situation.

Immediate postoperative check X-ray

Trinica Zimmer cervical miniplate


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Notice: Head injuries and very urgent surgeries are also escaped from the plan .

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